Department of Digestive Surgery, Timone Hospital, Aix Marseille Univ, APHM, 264 rue Saint-Pierre, 13005, Marseille, France.
Department of Intensive Care and Anesthesiology Department 2, Timone Hospital, Aix Marseille Univ, APHM, Marseille, France.
Int J Colorectal Dis. 2023 Aug 17;38(1):216. doi: 10.1007/s00384-023-04511-9.
To compare perioperative results of laparoscopic and robotic ventral mesh rectopexy for pelvic floor disorders at the beginning of the surgical experience.
Between 2017 and 2022, the first 30 laparoscopic ventral mesh rectopexies and the first 30 robotic ventral mesh rectopexies at the beginning of the experience of 2 surgeons were retrospectively analyzed. Perioperative (demographic characteristics, surgical indication, conversion rate, operative time), and postoperative (complications, length of stay, unplanned reintervention) data were compared between groups.
Demographic characteristics were similar between groups. Conversion rate was lower (0 vs 17%, p = 0.05), but the operative time was significantly longer (182 [146-290] vs 150 [75-240] minutes, p < 0.0001) during robotic procedure when compared with laparoscopic approach. In terms of learning curve, the number of procedures to obtain the same operative time between the 2 approaches was 15. Postoperative results were similar between groups, in terms of pain (visual analogic scale = 2 [0-8] vs 4 [0-9], p = 0.07), morbidity (17 vs 3%, p = 0.2), and unplanned reintervention (1 vs 0%, p = 0.99). Mean length of stay was significantly reduced after robotic approach when compared with laparoscopic approach (3 [2-10] vs 5 [2-11] days, p < 0.01). Functional results were better after robotic than laparoscopic ventral mesh rectopexy, with higher satisfaction rate (93 vs 75%, p = 0.05), and reduced recurrence rate (0 vs 14%, p = 0.048).
Despite longer operative time at the beginning of the learning curve, robotic ventral mesh rectopexy was associated with similar or better perioperative results than laparoscopic ventral mesh rectopexy.
比较腹腔镜和机器人腹侧网片直肠固定术治疗盆底功能障碍的围手术期结果，这些数据来自两位外科医生经验初期的前 30 例腹腔镜腹侧网片直肠固定术和前 30 例机器人腹侧网片直肠固定术。比较两组围手术期（人口统计学特征、手术适应证、转化率、手术时间）和术后（并发症、住院时间、非计划再干预）数据。
回顾性分析 2017 年至 2022 年期间两位外科医生经验初期的前 30 例腹腔镜腹侧网片直肠固定术和前 30 例机器人腹侧网片直肠固定术。比较两组围手术期（人口统计学特征、手术适应证、转化率、手术时间）和术后（并发症、住院时间、非计划再干预）数据。
两组患者的人口统计学特征相似。机器人组的转化率较低（0 比 17%，p=0.05），但与腹腔镜组相比，手术时间明显更长（182 [146-290] 比 150 [75-240] 分钟，p<0.0001）。在学习曲线方面，两种方法获得相同手术时间所需的手术例数为 15 例。在术后结果方面，两组患者的疼痛（视觉模拟评分 2 [0-8] 比 4 [0-9]，p=0.07）、发病率（17 比 3%，p=0.2）和非计划再干预（1 比 0%，p=0.99）相似。与腹腔镜组相比，机器人组的平均住院时间明显缩短（3 [2-10] 比 5 [2-11] 天，p<0.01）。与腹腔镜组相比，机器人组的功能结果更好，满意度更高（93 比 75%，p=0.05），复发率更低（0 比 14%，p=0.048）。
尽管在学习曲线的初期手术时间较长，但机器人腹侧网片直肠固定术与腹腔镜腹侧网片直肠固定术相比，其围手术期结果相似或更好。
